Landowner:

I have read and understand all the information on this application. I certify that the information herein is correct and understand that the premium is fully earned.

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Landowner

Hunt Club

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(By providing this address, you will receive renewal notification next year)

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Hunt Lease Association of America, LLC Insurance Program Summary

This is a Master Policy, with an effective date of August 1, 2017 to August 1, 2018. The effective date of your policy will be on August 1, 2017 or the day after the postmark date on the envelope containing your application and premium payment if received after August 1, 2017 and be in effect until August 1, 2018.

Premiums are not prorated if you apply after August 1, 2017. Premiums are 100% earned and there is no refund of premium if the policy is cancelled midterm by club or landowner. The material provided is for informational purposes only and is not intended to be a representation of coverage that may exist in any particular situation under a policy issued by Tokio Marine Specialty Insurance Company, Rated A+ (Superior). All conditions of coverage, terms and limitations are defined and provided for in the policy. Programs or products may not be available in all states and policy features may vary by state.

Lands that are subleased or used for any commercial hunting activities are not eligible for coverage in the program. The Master Policy is designed to cover the club’s recreational activities conducted on the land occupied by the hunting club.

Named Insureds: Scheduled Hunting Clubs of the Hunt Lease Association

of America, LLC.

Additional Insured’s: Scheduled landowner who leases land to hunt clubs.

Liability limits:

$1,000,000 per occurrence/$2,000,000 aggregate

$1,000 medical payments

$100,000 fire legal liability

No deductibles.

Club members are shown by endorsement as Additional Insured’s.

Coverage is provided for cross member liability. This is often referred to as “member to member” coverage.

The policy covers hunting clubs and members for liability resulting from bodily injury or property damage to third parties (e.g. guests, adjoining landowners, bystanders, etc.) for which the club or member is legally liable, subject to policy exclusions.

The use of ATVs and tree stands is not excluded under the policy.

Since this policy names the hunting club as the Insured and the landowner as the Additional Insured, each party will receive a certificate of insurance.

Notice: “This contract is delivered as surplus line coverage under the Non Admitted Insurance Act. The insurer issuing this contract is not licensed in Colorado but is an approved Non Admitted insurer. There is no protection under the provisions of the Colorado Guaranty Association Act.”

This application must be fully completed and all questions must be answered. If you need assistance, please call the policy administrator, Hunt Lease Association of America toll free at: 1-888-683-7808. This is an application for insurance, not a Binder for Insurance.

This material is for informational purposes only and is not intended to be a representation of coverage. Please read the policy for terms and conditions.